The US experiences a grossly disproportionate rate of firearm-related deaths in minors as compared to peer countries, and firearm deaths amongst the young account for more than 25% of the decreased life expectancy gap in America. The firearms industry, that is experiencing a long-term decline in American gun ownership, provides substantial financial support to the NRA and has had ties to that organization’s Board of Directors. The NRA has become a powerful lobbying force at both federal and state levels with a record of opposing legislation that would negatively affect firearms sales and advocating for legislation that expands firearm sales. That our elected representatives continue to enact firearm market expansion policies, without implementing tougher regulatory restraints on gun sales to curb firearm deaths in minors, represents the worst of special interest-driven politics and is nothing short of a dereliction of duty in governance.

Disproportionately Higher Death Rates and Decreased Life Expectancy

In examining the crude firearm homicide rate per 100,000 inhabitants in countries that have a population exceeding 3.8 million and a GDP per capita, adjusted for purchasing power, in excess of $20,000 (World Health Organization, 2002), the US rate dwarfs that of any other industrialized country (ref). The firearm homocide rate in the US was 5.5 times higher than Italy (the next highest) and several European Union countries reported insignificant levels of firearm homicides: only 45 were reported in the UK, 15 in Denmark, 10 in Norway, and 7 in Ireland. Whereas the US reported a total of 10,801 firearm homicides in 2000, the European Union, having a population of over 376 million (exceeding that of the US) reported only 1,260 firearm homicides. And in Japan, where less than 50 handguns were present (they are reserved to athletes participating in international shooting competitions), only 22 firearm homicides were reported. Despite the mantra that guns keep us safer, research published by Dr. Jean Lemaire (Professor of Insurance and Actuarial Science, Wharton School, University of Pennsylvania) has shown firearm deaths account for more than 25% of the decreased life expectancy gap of Americans compared to the other 34 richest countries, much higher than the combined effect of all colon and prostate cancers (ref). This effect on life expectancy is attributed to firearm deaths occurring at early ages. And there is some evidence that just owning a gun significantly increases the chances of dying, even when controlling for variables like neighborhood and education (ref).

The US experiences a grossly disproportionately higher rate of firearm deaths in children than other industrialized countries (ref). According to the CDC, the rate of firearm deaths in children under age 15 is almost 12 times higher in the US than 25 other industrialized countries combined. American children are 16 times more likely to be murdered with a gun, 11 times more likely to commit suicide with a gun, and nine times more likely to die in a firearm accident than children in those other countries. Firearm-related deaths in children under 15 years of age by country are graphically displayed below (ref).

As reported in a University of Michigan Health System report (ref), “when researchers studied the 30,000 accidental gun deaths of Americans of all ages that occurred between 1979-1997, they found that preschoolers aged 0-4 were 17 times more likely to die from a gun accident in the 4 states with the most guns versus the 4 states with the least guns. Likewise, school kids aged 5-14 were over 13 times more at risk of accidental firearm death in the states with high gun ownership rates. The findings indicate that gun availability is associated with accidental death by shooting”. Additionally, it was noted that more than 90% of suicide attempts with guns are deadly and teens in homes with firearms are at higher risk for committing suicide.

Although programs have been developed to educate parents and children about gun safety, the effectiveness of such programs in children is questionable (ref). In the June 2001 issue of Pediatrics a study was published entitled ‘Seeing is Believing: What Boys Do When They Find a Real Gun’ (ref). In that study, 29 groups of boys aged 8 – 12 years were observed in a room where a gun was hidden. Many of the children found and handled the gun, and half of the children actually pulled the trigger. ”More than 90% of the boys that handled the gun or pulled the trigger reported that they had previously received some sort of gun safety instruction.” And an article published by the American Academy of Pediatrics entitled “They’re Too Smart for That” (ref) examined parents’ beliefs about how children would react to finding guns, with particular emphasis on how parents reasoned about children’s actions. All respondents in the survey, regardless of gun ownership, geography, race, gender, education level, income, or child age, were equally likely (around 87%) to believe that their children would not touch guns they found, 52% reasoned that children were “too smart” or “knew better”. The conclusion of the article was that caregivers’ unrealistic expectations of children’s developmental levels and impulse control may effectively relieve adults of responsibility and place the burden on children to protect themselves.

The American Academy of Pediatrics identifies gun-related injuries as one of the leading causes of death in minors and issued the following in a position statement on the matter (ref): “Because firearm-related injury to children is associated with death and severe morbidity and is a significant public health problem, child health care professionals can and should provide effective leadership in efforts to stem this epidemic”.

Irresponsible Legislative Actions and Inactions

Despite the well established health risks that guns pose to minors, this past year Florida Governor Rick Scott, backed by the National Rifle Association (NRA), signed into law legislation that threatened physicians with disciplinary action, including fines or even loss of the license to practice medicine, for “unnecessarily harassing a patient about firearm ownership during an examination” – “unnecessary harassment” being left undefined (ref). And despite the role physicians have played in counseling families and patients on risks to children (e.g., household poisons, unsupervised swimming pools, riding bikes without safety helmets), the law prohibited physicians from even asking parents whether they have a gun in the home (unless the doctor has a “good faith” belief that it is “relevant to the patient’s medical care or safety”). Represented by lawyers from The Brady Center and the law firm of Ropes & Gray, three Florida physicians organizations, as well as several individual doctors, filed suit to strike down the law as a violation of the First Amendment; a preliminary injunction was granted by US District Judge Marcia G. Cooke, Southern District of Florida – Miami (ref).

And despite the disproportionate rate of firearm deaths in US citizens and minors, legislation is being, or has already been, enacted both federally as well as in multiple states that expand public exposure to guns without imposing tighter regulatory controls governing gun safety. H.R. 822, the National Right-to-Carry Reciprocity Act of 2011, passed the US House of Representatives and is pending in the US Senate. This legislation would allow those having concealed carry handgun permits to freely cross state borders with their weapons despite widely varying requirements across states in obtaining such a permit. As noted in a recent Washington Post editorial (ref), Washington State “has among the most lax guns laws in the country, requiring neither training nor permits before a purchase. The state does not compel registration and allows individuals without a serious criminal record or history of mental illness to obtain permits to carry a concealed weapon”. In conjunction with this legislation, states are passing laws that permit concealed carry permit holders to bring their weapons into public parks and restaurants (including those that serve alcohol) where children play and where our families dine.

On a broader level, US firearm agents estimate that around 80 percent of the weapons used by Mexican drug traffickers come from the US, where cartel leaders are hiring Americans with clean records to make the purchases for them; the drug war waged by these cartels has claimed more than 31,000 lives since late 2006 (ref) with some of the violence spilling over onto US soil including such tactics (as reported by the Tucson, AZ police) of placing a gun into a baby’s mouth and abducting children (ref). Despite our concerns over terrorism and the threat that extremist groups pose to the safety of our families and children, an American citizen working for al Qaeda posted a video calling on Americans to take advantage of lax gun laws here to better kill fellow Americans (ref). This operative stated: “What are you waiting for?…America is absolutely awash with easily obtainable firearms.” The video prompted a coalition of US mayors to contact Congress and President Obama to address what has been called a glaring threat to US national security. And both felons (ref) and individuals with a history of mental illness (ref), two classes that have taken the lives of innocent citizens, are finding it easier to have their gun rights restored in court. The Virginia Tech massacre that claimed 32 lives and wounded 25 others, and the attempted assassination of Arizona Representative Giffords that claimed six lives including that of nine-year-old Christina Taylor-Green, were both attributed to the mentally-ill acquiring guns.

So where are our elected representatives on this matter? Death is what is known as a ‘hard endpoint’ in assessing safety. With data clearly showing that US citizens, including minors, are experiencing a disproportionately higher rate of firearm death as compared to peer nations, why aren’t our legislators working to more tightly regulate the safety of this product? The answer lies with an organization that has become a powerful lobbying force in Washington DC, around the country, and has even been active internationally (ref) – the NRA.

The NRA: Ties to the Firearms Industry, Commercial Pressures, and Tactics

Ties to the Firearms Industry

The NRA and the gun industry are linked including ties to the organization’s Board of Directors (ref). And a document published by the Violence Policy Center entitled Blood Money: How the Gun Industry Bankrolls the NRA, details corporate donations to the organization (ref).

It has been reported that the NRA received between $19.8 million and $52.6 million through its Ring of Freedom corporate giving program, of which 74% (between $14.7 – $38.9 million) came from members of the firearm industry. The NRA’s Executive Vice President (and current chief), Wayne LaPierre, promised that the “National Rifle Association’s newly expanded Corporate Partners Program is an opportunity to corporations to partner with the NRA…This program is geared toward your company’s corporate interests”. Of the 22 “corporate partners” acknowledged in the Ring of Freedom, 12 manufacture assault weapons, and numerous high-capacity ammunition makers are additionally cited as “corporate partners”. MidwayUSA, a high-capacity ammunition magazine manufacturer is cited as having donated between $5,000,000 – $9,999,999 to the organization. Others, including Berretta USA Corp and Springfield Armory, Inc (manufacturers of guns, high capacity magazines, and gun accessories), and Pierce Bullet Seal Target Systems, LLC (manufacturer of gun accessories) are cited as having donated between $1,000,000 – $4,999,999 to the organization. A second program, The NRA Round-Up Program, created by MidwayUSA founder Larry Potterfield, allows buyers to “round-up” their purchase to the nearest dollar with the difference going to the NRA.

This activity represents a 180-degree turn from the organization’s position as noted in Americans and Their Guns, an official history of the organization published in 1967, which stated that the NRA “…is not affiliated with any manufacturer of arms or ammunition or with any jobber or dealer who sells firearms and ammunition”. Such a link of a not-for-profit organization to profit-making corporations raises valid concerns regarding the objectivity of the organization, such as the effectiveness of its Eddie Eagle “gun safety” program (the effectiveness of such programs in children is questionable as was discussed above).

It would be naive to believe that the firearms industry is contributing this level of funding to a powerful lobbying force solely for ideological purposes; i.e., Second Amendment rights. It is difficult to dismiss that this is also about special interest monies buying influence in DC to the benefit of the industry.

Continuing Decline of Gun Ownership in America and Commercial Pressures

An evaluation of national data spanning nearly 40 years (contained in the General Social Survey, the GSS, conducted by the National Opinion Research Center at the University of Chicago – the GSS being the most frequently analyzed source of information in the social sciences) shows that personal and household gun ownership in America has been in decline since the 1970′s (ref). From 1977 to 2010 the percentage of American household that reported having any guns in the home dropped more than 40 percent. And from 1985 to 2010, the percentage of Americans who reported personally owning a gun dropped more than 32 percent. Reasons cited for this decline include: the aging of the current-gun owning population, primarily white males; a lack of interest in guns by youth; the end of military conscription; the decreasing popularity of hunting; land use issues that limit hunting and other shooting activities; environmental land zoning issues that force shooting ranges to close and limit new range construction; and, the increase in single-parent homes headed by women.

As reported in Bloomberg (ref), this decline in gun ownership “makes the business imperative clear: to maintain profits, the industry must sell more guns to fewer people”, and thus raises a valid concern about NRA initiatives and the ties it has to the firearms industry. For example, concealed-carry laws enable manufacturers to appeal to old customers with new products “ranging from the Ceretta PX4 (‘well-suited for concealed carry’ according to the manufacturers website) to the Ruger SR40c (‘another srtong concealed carry option from Ruger’)…Colt’s Single Action Army Revolver…weighs 40 ounces – such ‘subcompact’ guns are easily hidden and cost less than $600″. Consider the NRA-supported Florida gag order on physicians enquiring about guns in the home as a safety issue; dissemination of information by the medical community about the risks to children in homes with guns could only negatively impact gun sales. Consider the NRA’s opposition to expanded criminal background checks on gun sales (including its support of a loophole allowing suspected terrorists to purchase guns without identification or background checks – ref). Expanded background checks could not only negatively impact gun sales in this country, but the flow of high powered weaponry our markets are providing the Mexican drug cartels as well – at the expense of the very corporations who are heavily funding the NRA.

Does this special interest organization wield influence over our elected officials? Consider the case of Senator David F. Durenberger (R- MN), as reported in the NY Times, who contacted the NRA seeking their support in rolling back a provision that permitted thousands of felons in his state, including those convicted of violent crimes, getting their gun rights back (ref). The senator’s chief of staff, Doug Kelley, stated that Senator Durenberger “ran into a stone wall” as the NRA threatened to pull its support for him if he did not drop the matter, which he eventually did.

Tactics: Manipulating Fear and Paranoia

Consider the NRA’s use of conspiracy theory and manipulation of paranoia and fear that has contributed to enhanced firearms and ammunition sales (ref). Although President Obama abandoned efforts to enact gun control legislation, earning him a F rating from the Brady Campaign Against Gun Violence, the NRA twisted the President’s actions as being a plot to secretly destroy the Second Amendment. NRA Executive VP Wayne LaPierre issued the following: “But it’s a big stinking lie, just like all the other lies that have come out of this corrupt administration. It’s all part – it’s all part of a massive Obama conspiracy to deceive voters and hide his true intentions to destroy the Second Amendment in this country…Before the President was even sworn into office, they met and they hatched a conspiracy of public deception to try to guarantee his re-election in 2012″. This was followed by another statement from La Pierre that a “second term by President Obama would break the back” of the Second Amendment. As was noted by MSNBC’s Rachel Maddow, “The NRA says the way you can tell Obama is coming for your guns, is that he’s not coming for your guns. It’s genius! That is the insane paranoid message from the NRA this year”. The article delves into other such manipulation of fear and paranoia by the organization.

The NRA made claims in mailers and TV ads during Obama’s 2008 campaign that the candidate planned to ban handguns, hunting ammunition, and use of a gun for home defense. FactCheck.org, a non-partisan, nonprofit “consumer advocate for voters” (ref), examined these claims and found them to be false (ref). The Obama campaign asked broadcasters to take down ads from the NRA as they were misleading, citing FactCheck.org’s work as well as a separate Washington Post article. The NRA attacked FactCheck.org on its web site claiming that the organization was neither impartial or independent. But consider the outcome. Gun sales surged after Obama’s election (ref). ”According to FBI figures for the week of November 3 – 9, 2008, the bureau received more than 374,000 requests for background checks on purchasers – a nearly 49 percent increase over the same period in 2007″. One gun store, the Virginia Arms Company, reported running out of some models such as the AR-15 rifle (the civilian version of the military’s M-16) and was running low on others. Such assault weapons were among the firearms that gun dealers and their customers say they feared Obama would hit with new restrictions or even take off the market. A similar spike in firearms sale occurred following the election of President Clinton. The firearms industry, that provides substantial funding to the NRA, was the ultimate financial beneficiary of this activity.

It’s time we question the NRA’s stated purpose of preserving Second Amendment rights. The organization is heavily tainted with firearm industry money and it is difficult to dismiss that what we are witnessing is a manipulation of our constitution, to the financial benefit of an industry, at the expense of American lives, including the youth of this country.

Discussion

It is difficult to support the argument that guns keep us safe when firearm deaths in America, including those in minors, are grossly disproportionately higher here than in peer countries and when firearms deaths are a leading contributor to the decreased life expectancy gap in America. In fact, it seems as if the pro-gun advocates feel the need to defend themselves from the consequences of widely available firearms that they advocate; a market where guns have been readily obtained by the mentally ill, convicted criminals, drug traffickers, and even terrorists.

My career was spent in generating and evaluating information assessing product safety in a regulated industry where I authored numerous benefit/risk documents in support of marketing applications and have been before federal regulators on issues of product safety. The overall safety of a product is assessed by an integration of benefit and risk, i.e. what is the intended use and purpose of the product and whether the benefits outweigh the risks. What one should be able to show is that the intended benefits outweigh the risks, and if risks exist what needs to be done to limit risk and enhance the overall benefit/risk ratio of the product. Although the risks of firearms have been well documented and quantitated (homicides, use for suicides, unintentional death), the claimed benefit of safety/protection is difficult to quantitate.

If the purpose of owning a handgun is for protection, the product is causing a substantial loss of life outside that intended purpose – not just to ordinary citizens, but to our law enforcement officers as well where this past year gun violence became their leading cause of death on the job (ref). And analysis has shown that although armed and trained, and in some cases wearing body armor, in 73% of the cases the officers were not able to defend themselves -they never saw it coming as they were the victims of ambush or surprise attacks, with the head typically being the target (ref). Police Chief Mike Wilson, Atchinson, KS, who lost a well-trained and protected officer to a surprise attack stated “When someone assassinates you from behind, all the training, education and equipment is sometimes not much help”.

Although claims have been made that the reduction we have seen in crime is associated with an increase in concealed carry licenses, it is well established that correlation does not imply causation and is an invalid approach upon which to draw conclusions (ref). That same mistake was made when multiple epidemiological studies led physicians to believe that women on hormone replacement therapy were at a lower risk of developing coronary heart disease; controlled studies demonstrated the opposite. Regarding guns, one could just as easily say the the decrease in crime is due to declining personal and household gun ownership in America.

Although it has been claimed that guns serve as a deterrent to crime, analysis of two matched cities (Seattle, WA and Vancouver, British Columbia, Canada) failed to support that claim (Handgun Regulations, Crime, Assaults, and Homicide: A Tale of Two Cities, JH Sloan, MD, et. al, New England Journal of Medicine, Vol. 319, No. 19, 1988, pp. 1256-1262). Although the two cities were shown to be largely similar, Vancouver had more restrictive gun ownership/possession requirements. Key findings from the study include: 1) although the assault rate was only slightly higher in Seattle than Vancouver, the rate of assault involving firearms was seven times higher in Seattle; 2) the risk of death from homicide was found to be significantly higher in Seattle than in Vancouver, this risk being explained by a nearly five-fold higher risk of being murdered with a handgun in Seattle as compared with Vancouver; and, 3) rates of homicide involving means other than guns were not substantially different in the two cities. That study, and others, have been summarized by the Violence Policy Center (ref).

And although gun owners are described as ‘law abiding citizens’ having the right to defend themselves, the disproportionately higher rate of firearm homicides in this country would indicate that there are plenty of ‘non-law abiding citizens’ in possession of guns. Investigative reporting by the NY Times recently matched concealed carry permit holders in NC (one of the dwindling number of states where this information is still available) to recent criminal court cases and found 2400 permit holders that had been convicted of a felony or misdemeanor (excluding traffic-related crimes) in the past 5 years – 10 committed murder or manslaughter, 8 with guns (ref). And when it comes to weaponry, just one individual can inflict a massive loss of life as has been seen on far too many occasions.

Even if a protective/deterrent benefit could be accurately quantified that offset the collateral damage from this product, such benefit is being obtained at a high price to our citizenry, including our youth. And frankly, when a product is associated with a substantial loss of life outside of its intended purpose, expanding public access and exposure to the product as a solution is both unusual and illogical.

Having been engaged in cancer research at the Medical College, University of AZ, in the 1970′s, what is occurring with the firearms industry is strikingly similar to what we witnessed with ‘Big Tobacco’ in the 1970′s and 1980′s that denied the health risks and continued market expansion activities that adversely affected our youth. In fact, the NRA was admired by Philip Morris management and cited as a template for carrying out effective pro-industry activities in which a corporation could not legally engage (ref). A January 1988 Phillip Morris Five Year plan stated: “In 1988 we intend to create local smokers’ rights associations throughout the US…We intend to link (the captains of these associations) to local, state and ultimately a national rights organization. Once the national organization is established and funded, we will … create a self-sustaining membership organization similar the National Rifle Association”. My belief, is that with the well-established health risks associated with firearms, that industry will eventually face the same regulatory pressures as did Big Tobacco, but not after much damage has been done.

Although it is well-known that special interests buy influence in our government, our legislators should find themselves in a particularly troublesome position in advocating legislation that expands public exposure to guns without addressing the substantial loss life with which the product is associated, especially in minors. We enact laws to protect minors in this country, and yet in this case our legislators are failing to take legislative action that could help prevent unnecessary loss of life. In fact, they are moving in the opposite direction. I submit that it was not the intent of the Second Amendment to justify the unnecessary loss of American lives. And for our legislators to be engaged in enacting market expansion policy for gun products, without implementing tougher regulatory restraints on gun sales to curb firearm deaths in minors, represents the worst of special interest-driven politics and is nothing short of a dereliction of duty in governance.

In a couple of past articles I have discussed the moral crisis we face as a country when our elected officials are continuing to support failed special interest-driven economic policy (backed by financial industry lobbyists) that has contributed to an increase in poverty (ref)(ref). Based on a 2000 study conducted by Columbia University’s School of Public Health, an estimate of lost US lives in 2009 due to poverty exceeded 1.2 million, including children – an estimated annual increase of over 350,000 lost American lives since 2000 while tax cuts to the wealthiest are preserved and heating subsidies and other safety net programs to the needy are being cut. So, the grossly disproportionate rate of firearm deaths in American minors must be but small potatoes to our special interest-driven legislators these days.

Acknowledgement: appreciation for editorial comments extended to Hilton J. Cancel (career law enforcement and President, North Carolinians Against Gun Violence)

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